Model Study of Blood Flow through a Stent in the Aorto-Iliac Bifurcation

Atherosclerotic ailments play a major role in industrial societies. Atherosclerotic disease causes stenotic narrowing of the arterial vessel system. These narrow passages can be widened with balloon angioplasty and stents are introduced to keep the passage open. In this study, stents designed for the aorto-iliac bifurcation are considered. Most of these stents used in peripheral arteries are self-expanding stents made from Nitinol, a thermo-reactive alloy. The insertion is done under radiographic control. However, the delicate metallic structure of the stent usually casts only a weak radiographic shadow and thus is difficult to detect. A stent with an innovative radio opaque tantalum marker (Luminexx®, C.R. BARD – Angiomed, Karlsruhe), overcomes this problem. However, the markers extend into the blood flow and the question arises whether the markers may cause the generation of thrombi. In a model study in an enlarged model of the aorto-iliac bifurcation with an inserted stent the flow was visualized. The enlarged scale permits the observation and video recording of the flow in great detail. The Reynolds similarity is kept. A subsequent analysis of the flow in the vicinity of the markers shows a short residence time. These results indicate that the additional markers do not increase the risk of thrombus generation.

Relationship between stroke volume and pneumocardiogram

The intratracheal pressure oscillations produced by the heartbeat, called the pneumocardiogram, were recorded in 15 dogs. It was found that a linear relationship existed between the amplitude of the major negative deflection of the pneumocardiogram and the cardiac stroke volume, the latter determined either by indicator dilution (avg r = 0.94) or by use of an electromagnetic flow probe (avg r = 0.95). This relationship existed in animals with both an open and a closed chest. The vector of left ventricular wall motion directed toward the lungs, determined by high-speed cineradiography of the motion of a tantalum marker inserted in the wall of the left ventricle, looked very similar to the pneumocardiogram. This study showed that the pneumocardiogram can be used as a noninvasive technique to measure changes in stroke volume and is caused primarily by the motion of the cardiac walls.